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28.11.2016 | Pancreatic Tumors | Ausgabe 5/2017

Annals of Surgical Oncology 5/2017

Shape and Enhancement Characteristics of Pancreatic Neuroendocrine Tumor on Preoperative Contrast-enhanced Computed Tomography May be Prognostic Indicators

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 5/2017
Autoren:
MD, PhD Hirohisa Okabe, MD, PhD Daisuke Hashimoto, MD Akira Chikamoto, MD, PhD Morikatsu Yoshida, MD, PhD Katsunobu Taki, MD Kota Arima, MD, PhD Katsunori Imai, MD Yoshitaka Tamura, MD Osamu Ikeda, MD, PhD, FACS Takatoshi Ishiko, MD, PhD, FACS Hideaki Uchiyama, MD, PhD, FACS Toru Ikegami, MD, PhD Norifumi Harimoto, MD, PhD Shinji Itoh, MD, PhD, FACS Yo-ichi Yamashita, MD, FACS Tomoharu Yoshizumi, MD, PhD, FACS Toru Beppu, MD, PhD Yasuyuki Yamashita, MD, PhD, FACS Hideo Baba, MD, PhD, FACS Yoshihiko Maehara
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1245/​s10434-016-5630-4) contains supplementary material, which is available to authorized users.

Abstract

Background

Prognostic indicators of the malignant potential of pancreatic neuroendocrine tumors (PNET) are limited. We assessed tumor shape and enhancement pattern on contrast-enhanced computed tomography as predictors of malignant potential.

Methods

Sixty cases of PNET patients undergoing curative surgery from 2001 to 2014 were enrolled onto our retrospective study. Preoperative enhanced CTs were assessed, and criteria defined for regularly shaped and enhancing tumors (group 1), and irregularly shaped and/or enhancing tumors (group 2). The relation of tumor shape and enhancement pattern to outcome was assessed.

Results

Interobserver agreement was substantial (kappa = 0.74). Group 2 (n = 24) was significantly correlated with synchronous liver metastasis (23 vs. 0 %), lymph node metastasis (36 vs. 3 %), pathologic capsular invasion (68 vs. 8 %), larger tumor size (30 vs. 12 mm), tumor, node, metastasis classification system (TNM) stage III/IV disease (46 vs. 3 %), and histologic grade 2/3 (41 vs. 0 %). Multivariate analysis revealed that tumor grade 2/3 and group 2 criteria correlated with tumor relapse (hazard ratio 6.5 and 13.6, P = 0.0071 and 0.039, respectively), and that only group 2 criteria were independently correlated with poor overall survival (hazard ratio 5.56e + 9, P = 0.0041).

Conclusions

Irregular tumor shape/enhancement on preoperative computed tomography is a negative prognostic factor after curative surgery for PNET.

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Zusatzmaterial
Supplementary material 1 (DOCX 17 kb)
10434_2016_5630_MOESM1_ESM.docx
Supplementary material 2 (TIFF 51680 kb)
10434_2016_5630_MOESM2_ESM.tiff
Supplementary material 3 (DOCX 14 kb)
10434_2016_5630_MOESM3_ESM.docx
Literatur
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